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Revision Surgery for Otosclerosis

Built from Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition

What’s inside

5 sections · 51 slides

  1. 01

    Scope of the Problem

    • Revision stapes surgery in context
    • Trends in primary and revision case volume
    • Indications for revision stapedectomy
    • Interval between primary and revision surgery
    • Hearing pattern after primary surgery

    5 slides

  2. 02

    Preoperative Workup

    • Patient factors associated with revision
    • History of delayed hearing deterioration
    • Causes when hearing never improved
    • Postoperative vertigo and dysgeusia
    • Value of the prior operative report
    • The audiogram in revision decision making
    • Word recognition and cochlear implant candidacy
    • Tympanometry findings after stapes surgery
    • Physical examination of the operated ear
    • Displaced bucket-handle prosthesis on otoendoscopy
    • Reparative granuloma and loose wire syndrome
    • Tuning fork testing and surgical candidacy

    12 slides

  3. 03

    Imaging

    • Indications for thin-slice temporal bone CT
    • Prosthesis on the footplate with incus necrosis
    • Measuring prosthesis depth in the vestibule
    • Round window patency and cochlear otosclerosis
    • Round window obliteration on temporal bone CT
    • Pneumolabyrinth and perilymphatic fistula
    • Air in the vestibule and lateral semicircular canal

    7 slides

  4. 04

    Preparation for Surgery

    • Counselling and equipment availability
    • Reconstruction options for incus necrosis
    • Hydroxyapatite bone cement technique
    • Hydroxyapatite cement applied for incus necrosis
    • Malleovestibulopexy and total ossicular replacement
    • Laser use in revision stapes surgery
    • Facial nerve dehiscence and thermal injury
    • Choice of anaesthesia for revision stapedectomy

    8 slides

  5. 05

    Hearing Outcomes

    • Air-bone gap closure after revision surgery
    • Revision outcomes compared with primary surgery
    • Recurrent versus persistent hearing loss
    • Intraoperative findings and hearing outcome
    • Prosthesis, laser and incus availability
    • Sensorineural hearing loss after revision
    • Complications of revision stapes surgery
    • Complication rates compared with primary surgery
    • Key points for practice
    • References
    • References (continued)
    • References (continued)
    • Haynes-Glasscock-Shambaugh Surgery of the Ear, Seventh Edition
    • Join our WhatsApp groups

    14 slides